Between 15 and 40% of cancer patients develop clinical anxiety and/or depression (Derogatis et al, 1983;Massie and Holland, 1990;Parle et al, 1996). Even for those ostensibly cured the prevalence remains appreciably higher than that of the general population a year or more after diagnosis (Devlen et al, 1987). This evidence, combined with significant pressure from service users, has led to increasing provision of psychological interventions in British oncology services. This has been piecemeal (Fallowfield, 1988) and guided more by local factors than evidence of efficacy. There is little evidence based consensus about optimal methods of intervention, appropriate standards for clinical practice and training, or whether service provision is best directed towards prevention or the treatment of disorder (Fallowfield and Roberts, 1992;Hopwood and Maguire, 1992;Brennan and Sheard, 1994).The impact of psychological interventions in oncology on psychosocial, disease, symptom and treatment side-effect outcomes has been evaluated in a relatively large number of trials which vary considerably in their research questions, methodology, settings and results. Meyer and Mark (1995) aggregated all psychological outcomes for 45 such trials and reported a small mean effect size of 0.24 standard deviations for a single aggregate measure of psychological outcome. Their broad entry criteria ensured the inclusion of a large number of trials but the resulting extreme heterogeneity in terms of diversity of research questions and outcome measures render the meaning of this aggregate finding difficult to assess. We conducted, therefore, two metaanalyses of trials of interventions which sought to treat or prevent anxiety and/or depression. The relevance of the findings to clinical practice and service provision is assessed. METHODS Identical methods were used for the two meta-analyses Search strategyMedline, PsycLit and BIDS social sciences computerized databases were searched using the using the keywords cancer, counselling, psychotherapy, psychological therapy, group support/therapy, relaxation, imagery and visualization. Citations in identified papers and reviews (Watson, 1983;Cunningham, 1988;Vachon, 1988;Harman, 1991;Andersen, 1992;Trijsburg et al, 1992), Aslib. index to theses (keywords cancer, counselling and psychotherapy), and Comprehensive Dissertation Abstracts: Psychology (keyword cancer) were manually searched. SummaryThe findings of two meta-analyses of trials of psychological interventions in patients with cancer are presented: the first using anxiety and the second depression, as a main outcome measure. The majority of the trials were preventative, selecting subjects on the basis of a cancer diagnosis rather than on psychological criteria. For anxiety, 25 trials were identified and six were excluded because of missing data. The remaining 19 trials (including five unpublished) had a combined effect size of 0.42 standard deviations in favour of treatment against no-treatment controls (95% confidence interval (CI) 0.08-0.74, ...

We propose a new extension to the purely functional programming language Haskell that supports compile-time meta-programming . The purpose of the system is to support the algorithmic construction of programs at compile-time.The ability to generate code at compile time allows the programmer to implement such features as polytypic programs, macro-like expansion, user directed optimization (such as inlining), and the generation of supporting data structures and functions from existing data structures and functions.Our design is being implemented in the Glasgow Haskell Compiler, ghc.

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As most current query processing architectures are already pipelined, it seems logical to apply them to data streams. However, two classes of query operators are impractical for processing long or infinite data streams. Unbounded stateful operators maintain state with no upper bound in size and, so, run out of memory. Blocking operators read an entire input before emitting a single output and, so, might never produce a result. We believe that a priori knowledge of a data stream can permit the use of such operators in some cases. We discuss a kind of stream semantics called punctuated streams. Punctuations in a stream mark the end of substreams allowing us to view an infinite stream as a mixture of finite streams. We introduce three kinds of invariants to specify the proper behavior of operators in the presence of punctuation. Pass invariants define when results can be passed on. Keep invariants define what must be kept in local state to continue successful operation. Propagation invariants define when punctuation can be passed on. We report on our initial implementation and show a strategy for proving implementations of these invariants are faithful to their relational counterparts.

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